After a long hiatus, Rhythm Nation is back with our first post of 2019! Thanks to Dr. Angarita-Jones for submitting this ECG for the post.
The patient is a 50-year-old man with hypertension, diabetes, hyperlipidemia who presents after syncope. His wife states that they were watching Game of Thrones when the patient slumped back on the couch and became unresponsive. He returned to baseline within 2 minutes, after which his wife drove him to the ED.
The patient states that he began having chest pain 2 days ago after he had an argument with his son about his son’s decision to pierce his tongue and spend the next 5 years living on long-distance trains in South America. His chest pain was worse this morning when he awoke, so he took Zantac and an aspirin and felt slightly better. He had seen his cardiologist 2 months ago for routine screening and was told that his ECG was “fine”.
The patient also reports nausea, lightheadedness, and shortness of breath.
Vital Signs: HR 100/min, BP 100/70 mm Hg, RR 24/min, T 98F, SpO2 100% on 2L O2
Exam: Calm and cooperative, mild diaphoresis, fine crackles b/l, 1+ pitting edema b/l LE
What do you see in this ECG?
Answer available here!
smrutidesai
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2 Comments
Miguel · July 29, 2019 at 10:17 am
The image is too small to interpret, can it linked to a larger image or have the size increased?
Thank you
Anonymous · July 30, 2019 at 7:10 pm
I feel like I’m supposed to say Afib but I think its a Junctional with PAC.